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Community-Acquired Pneumonia (CAP)

Pathway Background and Objectives

Community-Acquired Pneumonia (CAP) is one of the most common pediatric diagnoses, affecting approximately 2% of children annually. In 2011, the Pediatric Infectious Diseases Society and the Infectious Diseases Society of America released a new practice guideline with evidence-based recommendations for the management of CAP in otherwise healthy infants and children. Due to decreasing S. pneumoniae resistance, there is less need for broad-spectrum antibiotics to treat CAP. The new guidelines reflect this change in antimicrobial resistance. There is also new evidence to suggest the usage of procalcitonin and its role in determining antibiotic need, as well as the utility of MRSA nasal PCR to determine the need for MRSA coverage.

The objectives of this pathway are to:

  • Decrease variation in antibiotic usage
  • Decrease unnecessary use of broad spectrum antibiotics
  • Decrease unnecessary use of azithromycin
  • Optimize ampicillin/amoxicillin dosing for local pneumococcal resistance
  • Decrease antibiotic usage to shortest effective duration
  • Increase appropriate use of Oseltamivir

Algorithm

Download CAP Pathway Algorithm

Quality Metrics

  • Percentage of eligible patients treated per pathway
  • Percentage of patients with appropriate inpatient antibiotic selection
  • Percentage of patients with correct inpatient discharge antibiotic selection
  • Percentage of patients with correct inpatient discharge antibiotic dosage
  • Average duration of antibiotic coverage (inpatient + outpatient prescription)
  • Percentage patients who had a CBC, who also had procalcitonin drawn
  • Percentage of patients with a procalcitonin level ≤0.25 who receive an antibiotic
  • Percentage of patients who receive vancomycin or linezolid
  • Percentage of patients with negative MRSA PCR, and vancomycin or linezolid discontinued
  • Admit length of stay (days)

Educational Module

Download CAP Educational Module

Key References:

Pathway Contacts

  • Jennifer Girotto, PharmD
  • Grace Hong, APRN
  • Anand Sekaran, MD

Disclaimer

The clinical pathways in the above links have been developed specifically for use at Connecticut Children’s and are made available publicly for informational and/or educational purposes only. The clinical pathways are not intended to be, nor are they, a substitute for individualized professional medical judgment, advice, diagnosis, or treatment. Although Connecticut Children’s makes all efforts to ensure the accuracy of the posted content, Connecticut Children’s makes no warranty of any kind as to the accuracy or completeness of the information or its fitness for use at any particular facility or in any individual case.

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